Diagnosis
The patient is first asked about the course of the accident and the symptoms. As part of a physical examination, the doctor takes a look at the affected shoulder and usually already sees with the naked eye a malposition of the shoulder, swelling and bruising. To diagnose a scapula fracture, x-rays of the shoulder are taken. These x-rays can show the fracture. At the same time, the imaging serves to assess the injury and therefore plays an important role in therapy planning.
Therapy
The majority of shoulder blade fractures are treated conservatively. Type A fractures are always treated conservatively. The affected shoulder is immobilized with a Gilchrist dressing.
Physiotherapeutic exercises, such as pendulum exercises, are also used. Pain is treated with pain-relieving medication. An operation may be indicated for complicated shoulder blade fractures. Physiotherapeutic exercises are indicated after the operation in order to favourably influence the healing and freedom of movement of the shoulder.
When is an operation necessary?
In the case of a type B and type C fracture, it is decided individually whether surgery is necessary. In the case of a type scapula fracture, surgery is performed if an unstable fracture is present. A type C fracture is sent to the operating room if there is a particularly severe malposition, i.e. if the shoulder exceeds a certain degree of displacement and tilt. Surgery is always performed if the tilt is greater than 40 degrees.
Healing time
The bone is resilient again after about six weeks. However, the healing process takes longer. During the first four to six weeks after the fracture, the shoulder must be immobilized in order to heal.
In order to be able to move the shoulder well in the long term, physiotherapeutic exercises are then indicated. These are carried out over several months. After about three to six months, the affected shoulder should be fully functional again.
What can be the late effects?
Possible late consequences of a shoulder blade fracture are a continued restriction of movement of the affected shoulder and disturbances due to possible nerve damage caused by the accident or during the operation.Post-operative treatment with physiotherapy is very important to ensure a satisfactory healing process.
